Pulsed radiofrequency of the sphenopalatine ganglion for the treatment of atypical facial pain. Case Report.
DOI:
https://doi.org/10.47924/neurotarget201949Keywords:
atypical facial pain, sphenopalatine ganglion, pulsed radiofrequencyAbstract
Introduction: The sphenopalatine ganglion (SG) plays an important role in several pain syndromes in the head and face. Currently, the most commonly used interventional procedures in this anatomical region are blockages, radiofrequency lesions and peripheral neuromodulation. In this case report we will present a case of atypical facial pain treated with radiofrequency pulsed (PRF) lesion of SG.
Material and methods: Female patient, 24 years old, with a history of trigeminal neuralgia and positive response to conventional radiofrequency (CRF) in left trigeminal nerve a year ago, arrives by interconsultation presenting a picture of continuous headache and pains in the upper jaw, teeth of the upper arch and the left nasal region. After ruling out other causes of pain, exhausted the pharmacological instance (oral and intravenous), new episode with evaluation of pain scale VAS 10/10 and diagnostic confirmation by blockade of the sphenopalatine ganglion, we proceed to the realization of a lesion by pulsed radiofrequency (PRF) in this anatomical structure.
Results: The PRF was effective, after the procedure the pain crisis disappeared so there was no need to re-use rescue medication. After a month and a half of follow-up, the VAS scale was 2/10, managing residual pain with paracetamol 500 mg and pregabalin 75 mg / day. There were no complications during the procedure or side effects.
Discussion: The result achieved is consistent with that published in articles that present a considerable number of cases in which PRF was performed in SG. They describe complete pain relief (VAS scale 2/10) between 21% and 35% of cases, reduction in oral medication intake and absence of side effects.
Conclusion: The PRF of the SG is a useful interventional technique for the management of atypical facial pain when it is practiced in correctly selected patients, refractory to conservative treatment and intervened with the technological equipment, safety environment and knowledge of the corresponding technique.
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Copyright (c) 2019 Wendy Rojas Gareca, César R. Hurtado Celosia
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